Fri Jan 27 2023

150 articles - From Friday Jan 20 2023 to Friday Jan 27 2023

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Guidelines

Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…

Am J Gastroenterol

Guide to the Guidelines: Diagnosis and Management of Celiac Disease.

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Endoscopy

Curriculum for bariatric endoscopy and endoscopic treatment of the complications of bariatric surgery: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.

The recognition and management of gastrointestinal diseases that are more common in patients with obesity, along with participation in multidisciplinary teams where obese patients are evaluated, are mandatory. 3 : ESGE recommends that competency in bariatric endoscopy and the endoscopic treatment of the complications of bariatric surgery can be learned by attending validated training courses on simulators initially, structured training courses, and then hands-on training in tertiary referral centers.

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Meta-analysis

meta-analyses and systematic reviews

Aliment Pharmacol Ther

Meta-analysis: Enhanced liver fibrosis test to identify hepatic fibrosis in chronic liver diseases.

Meta-analysis revealed considerable variability in the ability of ELF to stage fibrosis across disease aetiologies. Research has mostly focused on viral hepatitis and NAFLD. There is currently a lack of data on the value of the ELF test in Alcohol-related liver disease and patients in primary care settings.

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Gastrointest Endosc

Comparative Diagnostic Performance of Different Techniques for Endoscopic Ultrasound-Guided Fine-Needle Biopsy of Solid Pancreatic Masses: A Network Meta-analysis.

"Modified wet suction" seems to provide high rates of integrity and adequate samples, although with high blood contamination. "No suction" technique performs significantly worse than other sampling strategies.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Machine learning liver histology scores correlate with portal hypertension assessments in nonalcoholic steatohepatitis cirrhosis.

The ML algorithm accurately predicted HVPG, CSPH, the development of varices and HVPG changes in patients with NASH cirrhosis. The use of ML histology model in NASH cirrhosis trials may improve the assessment of key outcome changes.

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Secondary bile acids improve risk prediction for non-invasive identification of mild liver fibrosis in nonalcoholic fatty liver disease.

Secondary BA levels were significantly increased in NAFLD, especially in those with mild fibrosis. The combination of serum BAs and clinical/biochemical biomarkers for identifying mild fibrosis merits further assessment.

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Am J Gastroenterol

Colon Cancer Screening and the End of Life: Is Age Just a Number?

Patient and caregiver preferences must also be thoroughly explored. Current models struggle with incorporating other colorectal cancer risk factors such as family history, previous adenomas, and modality of previous screening into recommendations and simulations, but are likely to improve with machine learning and whole electronic health record prediction-based approaches.

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Cost-Effectiveness of Vonoprazan-Based and Rifabutin-Based vs. Other Regimens as First-Line Treatment of Helicobacter pylori Infection in the United States.

H. pylori infection eradication with vonoprazan triple therapy would provide the greatest net health and monetary benefit from the perspective of US healthcare payers.

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Dementia frequently co-exists with hepatic encephalopathy but not other cirrhosis complications in US Veterans.

Dementia is commonly diagnosed in patients with cirrhosis and correlates with a diagnosis of HE, independent of alcohol use, brain injury, age, and other metabolic risk factors. Dementia did not correlate with other decompensating events. Increased awareness of the overlap between dementia and HE, as well as reliable diagnostic and treatment strategies is needed for the aging population of Veterans with cirrhosis.

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Dysphagia Days as an Assessment of Clinical Treatment Outcome in Eosinophilic Esophagitis.

Dysphagia Days represents a relevant clinical end point to capture dysphagia-related symptoms.

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Esophageal Hypervigilance and Visceral Anxiety Contribute to Symptom Severity of Laryngopharyngeal Reflux.

Esophageal hypervigilance and symptom-specific anxiety may be more important than reflux burden in LPR symptom perception.

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Impact of a Novel Digital Therapeutics System on Nonalcoholic Steatohepatitis: The NASH App Clinical Trial.

DTx for NASH was found to be highly efficacious and well-tolerated. Further evaluation of the DTx intervention for NASH in a phase 3 trial is warranted.

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Maternal Inflammatory Bowel Disease During Pregnancy and Infectious Disease in Offspring Younger Than 5 Years: A Population-Based Cohort Study.

Maternal CD, but not ulcerative colitis, was associated with an increased risk of infection in offspring younger than 5 years, of which adverse birth outcomes and anti-TNFa had a minor role. The association between anti-TNFa agents and pediatric infection could be partially explained by maternal CD.

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Pentosan Polysulfate-Associated Dysplasia in Patients With Inflammatory Bowel Disease: A Case Series.

Patients with IBD at 2 institutions who had taken PPS had high rates of colonic dysplasia leading to surgery. Patients who stopped PPS showed improvement in their colitis. PPS may play a causal role in the development of colitis and dysplasia.

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Physician decision-making about surveillance in older adults with prior adenomas - results from a national survey.

Studies to better evaluate the benefits/harms of surveillance colonoscopy in older adults, and decisional support tools that help physicians and patients incorporate such data are needed.

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The Contribution of Genetic Risk and Lifestyle Factors in the Development of Adult-Onset Inflammatory Bowel Disease: A Prospective Cohort Study.

Genetic and lifestyle factors were independently associated with susceptibility to incident CD and UC. Adherence to a favorable lifestyle was associated with a nearly 50% lower risk of CD and UC among participants at a high genetic risk.

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When to Stop Surveillance: Pancreatic Cysts.

Based on these criteria, discontinuation of surveillance at either 5 years or 10 years is recommended. Oversurveillance of patients with pancreatic cysts in the absence of high-risk and worrisome features is discouraged.

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Clin Gastroenterol Hepatol

Nonalcoholic Fatty Liver Disease (NAFLD) is Independently Associated with Higher All-Cause and Cause-Specific Mortality.

NAFLD is independently associated with all-cause, cardiac, and cancer mortality. Efforts must continue to raise awareness about NAFLD and develop care pathways and public health efforts to reduce NAFLD burden and associated mortality.

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Up-front endoscopy maximizes cost-effectiveness and cost-satisfaction in uninvestigated dyspepsia.

Non-invasive management strategies appear to result in inferior cost-effectiveness and patient satisfaction outcomes compared to strategies promoting up-front endoscopy. Therefore, additional studies are needed to evaluate the drivers of patient satisfaction to facilitate inclusion in value-based healthcare transformation efforts.

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Endosc Int Open

Comparison of bleeding following gastrointestinal endoscopic biopsy in patients treated with and without direct oral anticoagulants.

The PS analyses showed no significant differences in complications following gastrointestinal endoscopic biopsy between DOAC users and non-users. These results suggest the safety of endoscopic biopsy without DOAC withdrawal although the need for careful hemostasis remains.

Pubmed   Journal   ReadQx   PMC

Differences in color between early gastric cancer and cancer-suspected non-cancerous mucosa on linked color imaging.

The total color difference was almost the same between EGC and CSM; however, their color tones were different on linked color imaging. Although the color characteristics of EGC had high specificity, they also had low sensitivity.

Pubmed   Journal   ReadQx   PMC

Efficacy of the argon plasma coagulation in patients with weight regain after gastric bypass: a randomized control trial.

An important "new" weight gain was observed in the long-term, showing that obesity is a chronic disease that requires multidisciplinary and family care for life. Also, APC is a safe procedure with low adverse event rates.

Pubmed   Journal   ReadQx   PMC

Endoscopic ultrasound-guided gastroenterostomy for the management of gastric outlet obstruction: A large comparative study with long-term follow-up.

This large cohort study demonstrates the safety and palliation durability of EUS-GE as an alternative strategy for GOO palliation in select patients.

Pubmed   Journal   ReadQx   PMC

EUS-guided endoscopic internal drainage with lumen-apposing metal stent for symptomatic hepatic cysts: a case series (with video).

EUS-guided LAMS drainage permits treatment of symptomatic SHCs without recurrence and with few adverse events. Comparative studies are needed to consider this approach as first intention.

Pubmed   Journal   ReadQx   PMC

Food intolerance in patients with functional abdominal pain: Evaluation through endoscopic confocal laser endomicroscopy.

The results of our study indicate that eCLE is a clinically useful tool to evaluate patients with functional abdominal pain and adverse reaction to food and to create individualized dietary therapy with clinical benefit for patients.

Pubmed   Journal   ReadQx   PMC

Endoscopy

Can White Light Endoscopy or Narrow Band Imaging preclude routine biopsy of colorectal endoscopic mucosal resection scars? A multicentre randomized single-blinded crossover trial.

The accuracy of NBI for the diagnosis of recurrence was not superior to that of WLE. Endoscopic assessment of EMR scars with WLE and NBI achieved a NPV that precludes routine biopsy in cases of negative optical diagnosis.

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Endoscopic Management of Gastrointestinal Wall Defects, Fistulas Closure, and Stent Fixation Using Through-the-scope Tack and Suture System (with video).

The use of TTTS is an effective and safe method for the closure of large GI defects and can be utilized for fistula closure and stent fixation. TTSS is a valuable addition to the armamentarium of endoscopic closure devices.

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Longer procedural time increases the dysplasia detection rate during endoscopic surveillance of Barrett's esophagus.

In BE patients with no clearly visible dysplastic lesions, longer procedural time is associated with increased likelihood of dysplasia detection. Adequate time slots are required to perform good quality surveillance and maximise dysplasia detection.

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Risk of total metachronous advanced neoplasia at surveillance colonoscopy after detection of serrated lesions: A matched case cohort study.

Patients with SLs are at greater risk for developing T-MAN regardless of synchronous adenomas. Patients with SL and HRA, and those with large or proximal SSLs appear to be at greatest risk for T-MAN.

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The effect of antithrombotic treatment on the fecal immunochemical test for colorectal cancer screening: a nationwide cross-sectional study.

The PPV for CRC or high risk adenomas was decreased nearly twofold in patients treated with NOAC (adjusted RR 0.58, 95 %CI 0.51-0.66]). CONCLUSION : Antithrombotic treatment was associated with a decreased PPV in FIT-based CRC screening.

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Gastroenterology

Injectable, drug-eluting nanocrystals prevent fibrosis and stricture formation in vivo.

The current data lays the foundation for further studies to improve the management of a range of diseases and conditions characterized by tissue fibrosis.

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Modulating the Microbiome for Disease Treatment.

In this review we discuss potential bidirectional interactions between microbes and host, describe the changes in gut microbiota induced by probiotic and prebiotic approaches, and their potential clinical consequences and summarize how to develop a systematic approach to designing probiotics capable of altering the host microbiota in disease states, using Crohn's Disease (CD) as a model chronic disease. Understanding how the effective changes in the microbiome may enhance treatment efficacy may unlock the possibility of modulating the gut microbiome to improve treatment using a natural approach.

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The evolutionary landscape of colorectal tumorigenesis: recent paradigms, models and hypotheses.

These include: non-linear and neutral evolution; polyclonality of driver mutations and parallel evolution in adenomas, although only rarely in carcinomas; the ability of mutational processes to shape evolution against the force of selection; the presence of rare driver genes that function in the same signalling pathways as the longstanding canonical drivers; and the existence of selective windows that constrain the functional effects of cancer driver mutations within limits. Many of these nascent evolutionary paradigms are potentially important for treating CRCs as well as understanding their development.

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Gastrointest Endosc

Detection of duodenal villous atrophy on endoscopic images using a deep learning algorithm.

In this study, an AI algorithm outperformed endoscopy fellows and experts in the detection of villous atrophy on endoscopic still images. AI decision support significantly improved the performance of non-expert endoscopists. The stable performance on "difficult" images suggests a further positive add-on effect in challenging cases.

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Endoscopic submucosal dissection for early cancers or precancerous lesions of the upper gastrointestinal tract in cirrhotic patients with esophagogastric varices: Ten-year experience from a large tertiary center in China.

ESD is an effective and safe treatment for early cancers or precancerous lesions of the upper gastrointestinal tract in cirrhotic patients with EGV. The incidence of severe adverse events is very low due to the development of individualized clinical treatment strategies.

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Endoscopic ultrasound-guided fine-needle biopsy of solid pancreatic tumors with 3 versus 12 to-and-fro movements: A multicenter prospective randomized controlled study.

Diagnostic sensitivity and accuracy of EUS-FNB with 3-TAFs were not inferior to those with 12-TAFs for solid pancreatic lesions. The 3-TAFs group showed significantly less blood contamination in sampled tissues than the 12-TAFs group.

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Endoscopic ultrasound-guided transluminal drainage using lumen-apposing metal stent with or without coaxial plastic stent for treatment of walled-off necrotizing pancreatitis: a prospective bicentric randomized controlled trial.

The addition of a coaxial DPS within LAMS was associated with a significantly lower global rate of AEs and stent occlusion rate in EUS-guided drainage of WON.

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Gastrointestinal involvement in monkeypox.

Gastrointestinal involvement may develop in the early stage of the disease. Hence, diagnostic suspicion is fundamental for early diagnosis and management.

Pubmed   Journal   ReadQx   PMC

Long-Term Course of Gastric Submucosal Tumors: Growth Speed and Size-Increasing Factors.

Tumor growth in gastric GIMTs less than 9.5 mm in diameter and/or with calcification is rare. Follow-up intervals for these lesions could be extended.

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Longitudinal Outcomes of the Endoscopic Resection of Non-Polypoid Dysplastic Lesions in Patients with Inflammatory Bowel Disease.

In our IBD cohort patients with NP-CRD, after undergoing endoscopic resection, surveillance colonoscopy rather than colectomy was safe and effective. After complete removal of endoscopically resectable NP-CRD, surveillance colonoscopy should be considered a safe and effective first line strategy, rather than colectomy.

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Nomogram as a novel predictive tool for lymph node metastasis in T1 colorectal cancer treated with endoscopic resection: A nationwide, multicenter study.

This is the first nomogram to include submucosal invasion depth and tumor budding for use in routine pathological diagnosis based on data from a nationwide multi-institutional study. With this nomogram developed with real-world data decision-making for an appropriate treatment strategy for T1 CRC should improve.

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Polyp characteristics at screening colonoscopy and post-colonoscopy colorectal cancer mortality: a retrospective cohort study.

Polyp size =10 mm and high-grade dysplasia are associated with PCCRC mortality in screening patients. This data suggests that these patients might benefit most from surveillance colonoscopy.

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Prophylactic endoscopic gallbladder stenting for cholecystitis after covered metal stent placement for distal biliary obstruction.

Although the transpapillary approach to the gallbladder is not easy for patients with DBO, EGBS is effective in preventing cholecystitis associated with CSEMS.

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Gut

Akkermansia muciniphila counteracts the deleterious effects of dietary emulsifiers on microbiota and host metabolism.

Background Accumulating evidence indicates that some non-absorbed food additives, including emulsifiers carboxymethylcellulose (CMC) and polysorbate 80 (P80), can negatively impact intestinal microbiota, leading to microbiota encroachment, chronic low-grade intestinal inflammation and, subsequently, promotion of metabolic dysregulations. Detrimental impacts of emulsifier consumption on gut microbiota include depletion of the health-associated mucus-fortifying bacteria, as a probiotic can help maintain intestinal and metabolic health amidst the broad array of modern stresses that can promote chronic inflammatory diseases.

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Hepatic pIgR-mediated secretion of IgA limits bacterial translocation and prevents ethanol-induced liver disease in mice.

Our results highlight that dysfunctional hepatic pIgR enhances alcohol-associated liver disease due to impaired antimicrobial defence by IgA in the gut.

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Large-scale, national, family-based epidemiological study on Helicobacter pylori infection in China: the time to change practice for related disease prevention.

Background and aims Current practice on individual-based treatment to family-based management, and the notion has important clinical and public health implications for infection control and related disease prevention.

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Randomised phase 2 study (JADE) of the HBV capsid assembly modulator JNJ-56136379 with or without a nucleos(t)ide analogue in patients with chronic hepatitis B infection.

In patients with non-cirrhotic CHB, JNJ-56136379+NA showed pronounced reductions in HBV DNA and HBV RNA, limited HBsAg or HBeAg declines in patients who are NCT HBeAg positive, and was well tolerated, but no clear benefit with regards to efficacy of JNJ-56136379 over NA was observed.

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Hepatology

Enhanced mitophagy driven by ADAR1-GLI1 editing supports the self-renewal of cancer stem cells in hepatocellular carcinoma.

Our findings demonstrate a novel role of ADAR1 as an active regulator for LCSCs properties via editing GLI1 in the highly heterogeneous HCC.

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Intrahepatic osteopontin signaling by CREBZF defines a checkpoint for steatosis-to-NASH progression.

Osteopontin signaling by CREBZF represents a previously unrecognized intrahepatic mechanism that triggers liver fibrosis and contributes to the severity of NASH.

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Mechanisms of drug resistance in HCC.

It also discusses alterations in signaling pathways, dysregulation of apoptosis, modulations in the tumor microenvironment, involvement of cancer stem cells, changes in drug metabolism/transport, tumor hypoxia, DNA repair, and the role of microRNAs in drug resistance. Understanding the interplay among these factors will provide guidance on the development of new therapeutic strategies capable of improving patient outcomes.

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Mitochondrial pyruvate carrier 1 regulates fatty acid synthase lactylation and mediates treatment of nonalcoholic fatty liver disease.

In NAFLD, MPC1 levels are positively correlated with hepatic lipid deposition, the enhanced lactylation at FASN K673 site may be a downstream mechanism.

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Model to predict major complications following liver resection for HCC in patients with metabolic syndrome.

Patients undergoing liver resection for HCC and MS are at high risk of postoperative major complications and death. Careful patient selection, considering baseline characteristics, liver function, and type of surgery, is key to achieving optimal outcomes.

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Multi-Centered study of patient outcomes after declined for early liver transplantation in severe Alcohol-associated hepatitis.

Liver recompensation is infrequent among severe AH patients declined for LT. Higher MELD-Na and age were associated with short-term mortality, while only history of failed alcohol rehabilitation was associated long-term mortality. The distinction between survival and liver recompensation merits further attention.

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Regulatory role and translational potential of CCL11 in liver fibrosis.

Finally, several targeting strategies that aimed at blockading CCL11 signaling, either by administration of an antagonist to its receptor CCR3 or neutralizing antibodies against CCL11/CCR3, ameliorated liver fibrosis in mice. In conclusion, our data unveil a previously unrecognized role for CCL11 in liver fibrosis and provide proof-of-concept evidence that targeting CCL11 can be considered as an effective therapeutic approach.

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Runt-related transcription factor-1 ameliorates bile acid-induced hepatic inflammation in cholestasis through JAK/STAT3 signaling.

This study has gained initial evidence establishing the functional role of hepatocyte RUNX1 in alleviating liver inflammation during cholestasis through JAK/STAT3 signaling. Modulating hepatic RUNX1 activity could be a new therapeutic target for cholestasis.

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Serum FGF19 predicts outcomes of Kasai portoenterostomy in biliary atresia.

Increased serum FGF19 at KPE predicted inferior long-term native liver survival in biliary atresia and was associated with unsuccessful KPE, elevated serum primary bile acids, and ductular reaction.

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The association between hepatic steatosis and incident cardiovascular disease, cancer, and all-cause mortality in a US multi-cohort study.

In this large, multi-cohort study of participants with CT-defined hepatic steatosis, accounting for change in CVD risk factors over time attenuated associations between liver fat and overall mortality or incident CVD. Our work highlights the need to consider concurrent cardiometabolic disease when determining associations between NAFLD and CVD and mortality outcomes.

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The impact of right atrial pressure on outcomes in patients undergoing TIPS, An ALTA group study.

Pre-TIPS RAP is an independent risk factor for overall mortality following TIPS insertion. Higher pre-TIPS RAP increased the odds of early complications and overall portal hypertensive complications as potential mechanisms for the mortality impact.

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J Hepatol

A multicenter randomized-controlled trial of hypothermic oxygenated perfusion (HOPE) for human liver grafts before transplantation.

Exploratory findings suggest that HOPE decreases the risk of severe liver graft related events. NCT01317342).

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Absent expansion of AXIN2+ hepatocytes and altered physiology in Axin2CreERT2 mice challenges the role of pericentral hepatocytes in homeostatic liver regeneration.

We find no evidence of predominant expansion of the pericentral hepatocyte population during liver homeostatic regeneration. Our data highlight the importance of detailed preclinical model characterisation and the pitfalls which may occur when comparing across sexes and backgrounds of mice and the effects of genetic insertion into native loci.

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Alternative forms of portal vein revascularization in liver transplant recipients with complex portal vein thrombosis.

Alternative forms of portal vein anastomosis achieving physiological portal inflow (i.e., deriving at least some splanchnic blood to the transplant graft) offer acceptable post-transplant results in LT candidates with complex PVT. On the contrary, non-physiological portal vein anastomoses fail to resolve portal hypertension and should not be performed. Impact and implications Complex portal vein thrombosis (PVT) is a challenge in liver transplantation. Results of this international, multicenter analysis may be used to guide clinical decisions in transplant candidates with complex PVT. Extra-anatomical portal vein anastomoses deriving at least some recipient splanchnic blood flow to the transplant allograft offer acceptable results. On the other hand, anastomoses that derive only systemic blood flow to the allograft fail to resolve portal hypertension and should not be performed.

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Capsaicin receptor TRPV1 maintains quiescence of hepatic stellate cells in the liver via recruitment of SARM1.

Antifibrotic properties of TRPV1 are attributed to the prevention of HSC activation via the recruitment of SARM1, promisingly providing an attractive therapeutic strategy against liver fibrosis. Impact and implications We identified the neuronal channel protein TRPV1 as gatekeeper of quiescence in HSC, one driver cell of liver fibrogenesis and chronic liver disease. Physiologically expressed in healthy liver and consistently downregulated during liver fibrosis development, its therapeutic reexpression is expected to have few side effects, making it an attractive target diagnostic tool and drug candidate for industry and clinicians.

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External validation of the PAGE-B score for HCC risk prediction in people living with HIV/HBV coinfection.

For individuals with HIV/HBV coinfection, PAGE-B is a valid tool to determine the need for HCC screening. Impact and implications Chronic hepatitis B virus (HBV) infection is the most important cause of hepatocellular carcinoma (HCC) among people living with HIV, and valid risk prediction may guide HCC screening efforts to high-risk individuals. We aimed at validating PAGE-B, a risk prediction tool that is based on age, gender, and platelets, among 2963 individuals with HIV/HBV coinfection who received tenofovir-containing antiretroviral therapy. In the present study, PAGE-B showed good discrimination, adequate calibration, and a cut-off of less than 10 had a negative predictive value for developing HCC within 5 years of 99.4%. These results indicate that PAGE-B is a simple and valid risk prediction tool to determine the need for HCC screening among people living with HIV and HBV.

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Gut microbiota promote liver regeneration through hepatic membrane phospholipid biosynthesis.

As a consequence, liver regeneration and survival after liver surgery is severely impaired. Even though this study is preclinical, its results might allow physicians in the future to improve patient's outcome after liver surgery, by modulation of the gut microbiota or their metabolites.

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Hepatitis D virus interferes with hepatitis B virus RNA production via interferon-dependent and -independent mechanisms.

Our data indicate that HDV interferes with HBV through both IFN-dependent and IFN-independent mechanisms. Specifically, we uncover a new viral interference mechanism in which proteins of a satellite virus affect RNA production of its helper virus. Exploiting these finding could pave the way to the development of new therapeutic strategies against HBV. Impact and implications Although, the molecular mechanisms remained unexplored, it was known for long that despite its dependency, HDV decreased HBV viremia in patients. Here, using in vitro and in vivo models, we showed that HDV interferes with HBV through both IFN-dependent and IFN-independent mechanisms affecting HBV RNAs metabolism and we defined the HDV-induced modulation signature. The mechanisms we uncovered could pave the way to the development of new therapeutic strategies against HBV by mimicking and/or increasing the effect of HDAg on HBV RNAs and the HDV-induced modulation signature may allow to the draw correlation withthe responsiveness to IFN alpha treatment and thereby ultimately help in the management of HBV/HDV co-infected patients.

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Modelling the potential effectiveness of hepatitis C screening and treatment strategies during pregnancy in Egypt and Ukraine.

This is one of the first models to explore HCV screening and treatment strategies in pregnancy, which will be critical in informing future care and policy as more safety/efficacy data emerge. Universal screening and treatment in pregnancy could potentially improve both maternal and infant outcomes. Impact and implications In the context of two lower middle-income countries with high HCV burden (Egypt and Ukraine), we designed a decision analytic model to explore five different HCV testing and treatment strategies for pregnant women, with the assumption that treatment was safe and efficacious for use in pregnancy. Assuming DAAs in pregnancy reduced vertical transmission, model findings indicate optimal maternal and infant benefits with provision of universal (rather than risk-based targeted) screening and treatment during pregnancy the proportion of women diagnosed and cured by delivery would be 65% in Egypt and 70% in Ukraine (versus 0% with standard of care), and the proportion of infants that would be infected at the age of 6 months would decrease from 6.5% to 3.4% in Egypt, and from 7.9% to 3.6% in Ukraine, compared to standard of care. While future trials are needed to assess safety and efficacy of DAA treatment in pregnancy and impact on VT, there is increasing recognition that the elimination of HCV cannot leave entire subpopulations of pregnant women and young children behind. Our findings will be critical in informing policymakers in improving screening and treatment recommendations for pregnant women.

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Multi-omics profiling of cholangiocytes reveals sex-specific chromatin state dynamics during hepatic cystogenesis in polycystic liver disease.

In the present study, we elucidate a sex-specific epigenetic mechanism underlying the cholangiocyte state transition during hepatic cystogenesis and identify epigenetic drugs effectively slow cyst growth in male PLD mice. These findings underscore the importance of sex difference in the pathogenesis of PLD and may guide researchers and physicians to develop gender-specific personalized approaches for PLD treatment.

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Risk of liver fibrosis associated with long-term methotrexate therapy may be overestimated.

Diabetes was the most significant risk factor associated with liver stiffness =7.9 kPa (adjusted OR = 3.19, 95% CI 1.95 - 5.20, P <0.001). Regular use of non-steroidal anti-inflammatory drugs showed the strongest association with ELF =9.8 (OR = 1.76, 95% CI 1.20 - 2.56, P =0.003), suggesting the degree of joint inflammation in RA may confound ELF as a non-invasive marker of liver fibrosis CONCLUSION: The risk of liver fibrosis attributed to MTX itself might have been previously overestimated; there is a need to consider modifying current MTX therapy monitoring guidelines.

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Neurogastroenterol Motil

Initial assessment of medical post-traumatic stress among patients with chronic esophageal diseases.

Preliminary evidence suggests medical PTS affects few patients with esophageal disease. However traumatic procedures, most often associated with HRM, significantly increase PTS symptoms. The potential impacts of medical PTS on esophageal patient assessment and outcomes are considerable and warrants further study.

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Nurse practitioner-delivered cognitive-behavioral treatment as a novel implementation route for irritable bowel syndrome: A proof of concept.

NP-delivered exposure-CBT for IBS was initially feasible and acceptable with promising clinical improvements. Findings will inform a future NIH Stage 1B/ORBIT Phase IIB pilot randomized control trial.

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Positive psychological well-being: A novel concept for improving symptoms, quality of life, and health behaviors in irritable bowel syndrome.

Participants with IBS linked greater positive psychological well-being to moderated IBS symptoms and better HRQoL and health behavior participation. An intervention to cultivate greater well-being may be a novel way to mitigate IBS symptoms, boost health behavior participation, and improve HRQoL in IBS.

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Smartphone app-delivered gut-directed hypnotherapy improves symptoms of self-reported irritable bowel syndrome: A retrospective evaluation.

Adherence to app-delivered gut-directed hypnotherapy was low but users who completed the program saw notable improvements in their IBS symptoms. Patients =40 years, with symptoms for =5 years, may respond better. A controlled trial comparing face-to-face to app-delivered GDH is indicated.

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The epidemiology and burden of gastroparesis: Real-world data from a large healthcare provider in Israel.

Gastroparesis is uncommon or under-documented in community care settings. Gastroparesis in general is associated with cardiovascular morbidities, lower BMI, and elevated utilization of healthcare services.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Aliment Pharmacol Ther

Review article: controversies surrounding the use of carvedilol and other beta blockers in the management of portal hypertension and cirrhosis.

With increasing evidence of benefit independent of variceal bleeding, namely retardation of decompensation and improvement in survival, it is time to consider whether carvedilol should be offered to al patients with advanced chronic liver disease.

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Clin Gastroenterol Hepatol

Blue Notes.

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Promoting Prognostic Understanding and Health Equity for Patients With Advanced Liver Disease: Using "Best Case/Worst Case".

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Endosc Int Open

LAMS for symptomatic hepatic cysts: beyond the boundary.

Pubmed   Journal   ReadQx   PMC

Gastrointest Endosc

Something positive from something negative.

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Gut

Understanding neuroimmune interactions in disorders of gut-brain interaction: from functional to immune-mediated disorders.

The interaction between immune activation and an impaired barrier function of the gut is most likely a bidirectional one with alterations in the microbiota, psychological stress and food components as upstream players in the pathophysiology. Only few immune-targeting treatments are currently available, but an improved understanding through a multidisciplinary scientific approach will hopefully identify novel, more precise treatment targets with ultimately better outcomes.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Am J Gastroenterol

A Rare Cause of Colonic Obstruction in Inflammatory Bowel Disease.

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Gastric Sarcoma: A Very Rare and Aggressive Gastric Cancer.

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How to Diagnose and Manage Cyclic Vomiting Syndrome?

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Inverted Meckel Diverticulum Diagnosed, Treated, and Followed Up by Enteroscopy.

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Practical Management of HRS-AKI in the Era of Terlipressin: What the Gastroenterologist Needs to Know.

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Practical Use of Rebyota for the Prevention of Recurrent Clostridioides difficile Infection.

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Socioenvironmental Stressors, Gut Microbes, and Colorectal Cancer Inequities: A Chicago Perspective.

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Endosc Int Open

Successful resection of large submucosal tumor in the esophagus: Novel thoracoscopic-endoscopic combined surgery with submucosal tunneling method.

Pubmed   Journal   ReadQx   PMC

Endoscopy

A novel endoscopic clip for closing a large perforating wound in a patient undergoing endoscopic full-thickness resection.

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A novel peroral pancreatoscopy combined endoscopic ultrasonography-assisted rendezvous procedure: a new strategy for bridging disconnected pancreatic duct syndrome.

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A novel tapered plastic stent with an ultrafine delivery system for one-step endoscopic ultrasound-guided hepaticogastrostomy.

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Bilateral stent-in-stent placement of biliary metal stents with a slim delivery system through an ultraslim endoscope.

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Cryotherapy for the treatment of benign refractory rectal bleeding.

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Cutting into the black sea: endoscopic submucosal dissection using a clip with line for a rectal polyp with severe fibrosis after tattooing.

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Direct compression hemostasis using a balloon dilator for bleeding after esophageal stent placement.

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Endoscopic ultrasound-guided gastroenterostomy using a novel dumbbell-shaped fully covered metal stent for afferent loop syndrome with long interluminal distance.

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Endoscopic ultrasound-guided hepaticojejunostomy for drainage of the right posterior hepatic duct enabled total liver drainage.

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Endoscopic ultrasound-guided transgastric pyogenic liver abscess drainage using a drill dilator.

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Endoscopy E-Videos - recently published.

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Intra-abdominal haemorrhage following an endoscopic retrograde cholangiopancreatography-related procedure: a rare complication.

Pubmed   Journal   ReadQx   PMC

Is there a role for endoscopic management of the large bowel in familial adenomatous polyposis?

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Lumen-apposing metal stent placement after endoscopic ultrasound-guided duodenojejunal anastomosis for direct access to excluded jejunal limb: findings after 5 years.

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Prefixed purse-string suture used as a new approach to resect a submucosal tumor in the ileocecal region.

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Proximal serrated polyp detection rate and post-colonoscopy colorectal cancer: the missing link.

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Recanalization using a novel drill-shaped dilator for a severe pancreatic duct stricture and impacted pancreatic duct stone.

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Redo endoscopic sleeve gastroplasty.

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Removal of a broken percutaneous transhepatic biliary drainage catheter by cholangioscopy through a lumen-apposing metal stent used for choledochoduodenostomy.

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Transcolonic lumen-apposing metal stent placement complicating a palliative endoscopic ultrasound-guided gastrojejunostomy.

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Water-immersion and cap-assisted endoscopic ablation of hemorrhagic radiation proctopathy with a novel 1.9/1.5-µm dual-emission endoscopic laser treatment.

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Gastroenterology

Circulating Mitochondrial DNA as a Diagnostic Biomarker for Predicting Disease Severity in Patients with Acute Pancreatitis.

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Identification of the d IEL-secreted Paneth cell protective factor API5 as a promising therapeutic target for ATG16L1-associated Crohn's disease.

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Promoting Prognostic Understanding and Health Equity for Patients With Advanced Liver Disease: Using "Best Case/Worst Case".

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Recurrent lower abdominal pain, altered bowel habits and malaise: Conservative or surgical approach to a common disorder.

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Repurposing UDCA, an FXR Inhibitor, to Prevent SARS-Cov-2 Infection.

Pubmed   Journal   ReadQx   PMC

The impact of proportional dietary carbohydrate and fat content upon type 2 diabetes and NAFLD.

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Gastrointest Endosc

A novel method of lithotripsy of large luminal bezoar stone using ERCP guidewire.

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Conservative treatment of perforation during endoscopic submucosal dissection of lower rectal tumor using an endotracheal tube.

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Endoscopic Balloon Dilation of Crohn's Related Strictures.

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EUS-Guided Ethanol Ablation for Management of Lung Carcinoma (with video).

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Inadvertent double puncture of the stomach and duodenum during EUS-guided pseudocyst drainage: Caution against puncturing from the gastric antrum.

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Krukenberg tumors metastasized from a T1a gastric carcinoma.

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LESIONS MIMICKING COLONIC POLYPOSIS.

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Peroral cholangioscopic findings of acute ischemic cholangiopathy caused by transarterial chemoembolization.

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Primary Gastric Mucormycosis.

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Pyogenic granuloma of the colon observed by magnifying endoscopy and treated by endoscopic submucosal dissection.

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Hepatology

Adjuvant treatment for biliary tract tumours: lost in a maze?

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February 2023 Hepatology Highlights.

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In memoriam: Robert K. Ockner, MD.

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Letter to the editor: discussing the place of TIPS in noncirrhotic patients with chronic extrahepatic portal vein occlusion (EHPVO).

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Letter to the editor: There may be a misunderstanding about the function of circular RNA as miRNA sponges.

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Reply: insurance should cover vancomycin for primary sclerosing cholangitis.

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Will noninvasive screening for fibrosis/steatosis open Pandora's box? Sharing the healthcare burden of state-of-the-art hepatology practice.

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J Hepatol

From the Editor's Desk...

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Neurogastroenterol Motil

Twenty-four-hour ambulatory oesophageal manometry in normal subjects (cooperative study).

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Letters&Replies

Letters to the editors and authors’ replies

Endosc Int Open

Premedication with simethicone and N-acetyl cysteine in esophagogastroduodenoscopy: Is it time to use it in practice?

Pubmed   Journal   ReadQx   PMC

Gastroenterology

Assessing the level of expertise of endoscopists in optical diagnosis of colorectal polyps - Not every expert is an expert.

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Bowel Wall Layer Thickness in Ulcerative Colitis on Endoscopic Ultrasound.

Pubmed   Journal   ReadQx 

Prospective, Multi-Institutional, Real-Time Next-Generation Sequencing of Pancreatic Cyst Fluid.

Pubmed   Journal   ReadQx 

RE: Proton pump inhibitors and mortality.

Pubmed   Journal   ReadQx 

Re: The Diagnostic Specificity in Blood-based miRNA Signatures Should be Fully Evaluated.

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Response to the Letter to the Editor.

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Gastrointest Endosc

Are sex-specific benchmarks for clinically significant serrated polyp detection warranted?

Pubmed   Journal   ReadQx 

Changing "master and slave" terminology in robotic-assisted technologies.

Pubmed   Journal   ReadQx 

Hemostatic powders as monotherapy or a rescue therapy in malignancy-related gastrointestinal bleeding: urgent need for large randomized controlled trial.

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Hybrid argon plasma coagulation after endoscopic mucosal resection-some caveats in the comparison with snare tip soft coagulation.

Pubmed   Journal   ReadQx 

Gut

Conclusion that autoimmune gastritis does not predispose to gastric cancer is unproven.

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Effect of rapid colonic transit on stool microbiome and short-chain fatty acids in diarrhoea-predominant irritable bowel syndrome.

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Haemorrhoidal disease reduces the risk of diverticular disease and irritable bowel syndrome: a Mendelian randomisation study.

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Is the significant risk of perioperative complications associated with radical surgery following non-curative endoscopic submucosal dissection for early colorectal cancer still acceptable?

Pubmed   Journal   ReadQx 

J Hepatol

3P and 5P model of limited value for the detection of clinically significant portal hypertension in patients with hepatitis delta.

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Neurogastroenterol Motil

Chagas' disease achalasia may represent a sub-group of type 2 achalasia without focal elevated pressures.

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